The National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
J Med Econ. 2019 Jan;22(1):95-107. doi: 10.1080/13696998.2018.1549055. Epub 2018 Dec 6.
To investigate preferences for fertility treatment from the Australian general population with the aims of calculating the willingness to pay in tax contribution for attributes (characteristics) that make up treatment and for an "ideal" fertility treatment program. We also assessed whether willingness-to-pay varies by the relationship status or sexual orientation of the patient. A stated preference discrete choice experiment was administered to a panel of 801 individuals representative of the Australian general population. Seven attributes of fertility treatment under three broad categories were included: outcome, process, and cost. Attributes were identified through published literature, focus group discussions, expert knowledge, and a pilot study. A Bayesian fractional experimental design was used, and data analysis was performed using a generalized multinomial logit model. Further analyses included interaction terms and latent class modeling. Six of the seven attributes influenced the choice of a treatment program. Under process attributes, individuals preferred: continuity of care of clinic staff, where patients are seen by the same doctor but different nurses at each visit; "alternative" treatments being offered to all patients; and onsite clinic counseling and peer-support groups. Personalization and tailoring of the treatment journey were not important. Among outcome attributes, the improved success rate of having a baby per cycle and significant side-effects were considered important. Cost of treatment also influenced the choice of treatment program. Individual preferences for fertility treatment were not associated with patients' relationship status or sexual orientation. Latent class modeling revealed sub-groups with distinct fertility treatment preferences. This study provides important insights into the attributes that influence the preferences of fertility treatment in Australia. It also estimates socially-inclusive willingness-to-pay values in tax contributions for an "ideal" package of treatment. The results can inform economic evaluations of fertility treatment programs.
为了调查澳大利亚普通人群对生育治疗的偏好，目的是计算为构成治疗的属性和“理想”生育治疗方案支付税款的意愿。我们还评估了患者的关系状况或性取向是否会影响支付意愿。我们向一个由 801 名代表澳大利亚普通人群的小组进行了一项基于陈述偏好的离散选择实验。实验纳入了生育治疗的七个属性，分为三个大类：结果、过程和成本。属性是通过已发表的文献、焦点小组讨论、专家知识和试点研究确定的。采用贝叶斯分数实验设计，使用广义多项逻辑模型进行数据分析。进一步的分析包括交互项和潜在类别建模。七个属性中的六个影响了治疗方案的选择。在过程属性方面，个人更喜欢：诊所工作人员提供的持续护理，即患者每次就诊都由同一名医生但不同的护士接待；为所有患者提供“替代”治疗；以及现场诊所咨询和同伴支持小组。治疗过程的个性化和定制化并不重要。在结果属性方面，提高每个周期的受孕成功率和显著的副作用被认为是重要的。治疗成本也影响了治疗方案的选择。个人对生育治疗的偏好与患者的关系状况或性取向无关。潜在类别建模揭示了具有不同生育治疗偏好的亚组。这项研究提供了有关影响澳大利亚生育治疗偏好的属性的重要见解。它还估计了为“理想”治疗方案支付税款的社会包容性支付意愿值。研究结果可以为生育治疗方案的经济评估提供信息。
